Accountable Care Program Implementation and Effects on Participating Health Care Systems in Washington State

2019 ◽  
Vol 42 (4) ◽  
pp. 321-336 ◽  
Author(s):  
Suzanne J. Wood ◽  
Elaine M. Albertson ◽  
Douglas A. Conrad
Author(s):  
Sura Alwan ◽  
Magdalena Dybalski ◽  
Irene M. Yee ◽  
Talitha M. Greenwood ◽  
Elaine Roger ◽  
...  

Abstract:Objective:To determine whether different health care systems may affect reproductive decision-making among patients with Multiple Sclerosis (MS), we describe the reproductive practices and attitudes of Canadian MS patients ascertained from the multidisciplinary MS Clinic at Hôpital Notre-Dame in Montreal, Quebec (NDMSC), in comparison to those of matched American selfregistrants from the database of the North American Research Committee on Multiple Sclerosis (NARCOMS).Methods:A total of 665 self-administered questionnaires on reproductive practices were sent out to eligible attendees attending the NDMSC. The short questionnaires were completed and returned to the authors in an anonymous format for analysis.Results:A total of 459 completed questionnaires were returned. The majority of NDMSC respondents (72.5%) and NARCOMS subset (75.2% females), did not encounter a pregnancy following diagnosis of MS. The most common MS-related reason for this decision was “symptoms interfering with parenting” (75.0% for the NDMSC, 72.6% for the NARCOMS). The most commonly reported non-MS-related reason was “a completed family” by the time of diagnosis in both the NDMSC and NARCOMS subset (58.0%, 40.4%, respectively). Concerns about financial issues both related and unrelated to MS were also commonly reported by males and females in both cohorts but significantly more so among the NARCOMS participants.Conclusion:These results indicate that reproductive decisions of MS patients are highly affected by their illness and its associated disability, regardless of the available health care program. Health care providers should discuss their patients' reproductive needs and perceptions to help them make more informed decisions.


2004 ◽  
Vol 171 (4S) ◽  
pp. 42-43 ◽  
Author(s):  
Yair Latan ◽  
David M. Wilhelm ◽  
David A. Duchene ◽  
Margaret S. Pearle

2014 ◽  
Vol 1 (1) ◽  
pp. 41-46
Author(s):  
Nevin Altıntop

What is the perception of Turkish migrants in elderly care? The increasing number of elder migrants within the German and Austrian population is causing the challenge of including them in an adequate (culturally sensitive) way into the German/Austrian health care system. Here I introduce the perception of elder Turkish migrants within the predominant paradigm of intercultural opening of health care in Germany as well as within the concept of diversity management of health care in Vienna (Austria). The qualitative investigation follows a field research in different German and Austrian cities within the last four years and an analysis based on the Grounded Theory Methodology. The meaning of intercultural opening on the one hand, and diversity management on the other hand with respect to elderly care will be evaluated. Whereas the intercultural opening directly demands a reduction of barriers to access institutional elderly care the concept of diversity is hardly successful in the inclusion of migrants into elderly care assistance – concerning both, migrants as care-givers and migrants as care-receivers. Despite the similarities between the health care systems of Germany and Austria there are decisive differences in the perception and inclusion of migrants in elderly care that is largely based on an 'individual care' concept of the responsible institutions. Finally, this investigation demonstrates how elderly care in Germany and Austria prepares to encounter the demand of 'individual care' in a diverse society.


2015 ◽  
Vol 1 (2) ◽  
pp. 321-346 ◽  
Author(s):  
Shiri Noy ◽  
Patricia A. McManus

Are health care systems converging in developing nations? We use the case of health care financing in Latin America between 1995 and 2009 to assess the predictions of modernization theory, competing strands of globalization theory, and accounts of persistent cross-national differences. As predicted by modernization theory, we find convergence in overall health spending. The public share of health spending increased over this time period, with no convergence in the public-private mix. The findings indicate robust heterogeneity of national health care systems and suggest that globalization fosters human investment health policies rather than neoliberal, “race to the bottom” cutbacks in public health expenditures.


2017 ◽  
Vol 1 (1) ◽  
pp. 41
Author(s):  
Angeliki Moisidou

A statistical analysis has been conducted with the aim to elucidate the effect of health care systems (HSs) on health inequalities assessed in terms of (a) differential access to health care services and (b) varying health outcomes among different models of HSs in EU-15 ((Beveridge: UK, IE, SE, FI, DK), (Bismarck: DE, FR, BE, LU, AT, NL), (Southern European model: GR, IT, ES, PT)). In the effort to interpret the results of the empirical analysis, we have ascertained systematic differences among the HSs in EU-15. Specifically, it is concluded that countries with Beveridge HS can be characterized more efficient (than average) in the most examined correlations, showing particularly high performance in the health sector. Similarly, countries with Bismarck HS record fairly satisfactory performance, but simultaneously they display more structural weaknesses compared with the Beveridge model. In addition, our empirical analysis has shown that adopting Bismarck model requires higher economic cost, compared with the Beveridge model, which is directly financed by taxation. On the contrary, in the countries with Southern European HS, the lowest performances are generally identified, which can be attributed to the residual social protection that characterizes these countries. The paper concludes with a synthesis of the empirical findings of our research. It proposes some directions for further research and presents a set of implications for policymakers regarding the planning and implementation of appropriate policies in order to tackle health inequality within HSs.


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